How Not to Get Sick in a Crowd

From sniffling sports fans to filthy arena restroom faucets, crowds breed germs. You can catch measles just by walking into a room and breathing.

By Jaimie Dalessio Clayton

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If you find yourself among hundreds or thousands in a stadium, an arena, or another big entertainment venue, prepare to get your hands on something other than a hot ticket.

Germs.

Medical researchers have investigated germs circulated in confined spaces, like airplanes, "where certainly there have been influenza, even tuberculosis outbreaks," says Gregory Poland, MD, director of the Vaccine Research Group at Mayo Clinic in Rochester, Minn. Similarly, researchers have tracked germs in hospitals and office buildings where relatively large numbers of people congregate.

"But in a football game or baseball game, everyone is so anonymous it's hard to track people, " Dr. Poland says, but "it's quite reasonable to extrapolate. If it happens in an office, you can bet it happens with 30,000 people."

What's Making You Sick?

What you're most likely to catch in a crowded setting, says Poland: first, respiratory illnesses — a sore throat, the common cold, influenza, a sinus infection, or bronchitis, for example, followed by gastrointestinal illnesses from eating uncooked or undercooked food. Jeanette Rainey, an epidemiologist with the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, agrees.

The spread of infection at mass gatherings like sporting events and concerts is something Dr. Rainey and her colleagues hope to better understand. “We want to be able to quantify mixing patterns at these gatherings in order to determine the probability of influenza or another bacterial infection among attendees,” she says.

Factors that could increase risk of getting sick at a mass gathering include the number of people in attendance, the type of venue, and the type of infections people carry into it. But what really influences it, Rainey says, is how people mix with each other at the event. Measles, for example, aerosolizes when someone coughs or sneezes and can spread quite far — meaning, if you are susceptible, you can walk into a large room and contract it just by breathing, says Rainey. It's that contagious.

You can also get influenza by coming into contact with large droplets when someone with flu coughs or sneezes, but flu droplets generally don't spread farther than six feet from the infected person. If you're out of that circle, you're likely at less risk. "However, most scientists think the flu can also be spread by breathing in aerosols containing the influenza virus or by touching contaminated objects and then touching your mouth, nose, or eyes," Rainey says. "But more research is needed to better understand how often this occurs."

Avoiding Infection in Crowds

Aside from not leaving the house, what can you do to protect yourself from crowd-sourced infections?

"I tell people it's a little like how we educated people about sex and HIV," Holland says. "When you have sex with someone, you're having sex with everybody they've had sex with. Touching common objects is touching objects that hundreds or thousands of people have touched."

Here are Poland's top three suggestions for staying well even when you are around hundreds of people:

A Critical Way to Keep Germs at Bay

Picking up germs all day, every day, wouldn't be such a big deal if you didn'talsotouch your face so often. That's a major way you let germs get inside your body.

Studies show that "the average American is putting their hand in their eyes, nose, mouth, or face every 20 seconds," Poland says. "It's amazingly frequent, so you may think you're not but chances are you are."

In fact, you're probably touching your face right now, aren't you?

Picking Up Exotic Illnesses From a Global Crowd

While an Olympic spectator may be more likely to contract a serious bacterial infection or virus from another country — bringing together hundreds of thousands of people from around the world worries experts about something like a measles outbreak, for example — catching the common cold at a concert in your hometown is nothing to sneeze at.

"[Having a cold] is common enough that all of us have had the experience, and they're not fun," Holland notes. But "they cost us a lot in terms of lost school and work time, and productivity and quality of life. You spend, over the course of a lifetime, an estimated three years of life sick with respiratory infections. It's not trivial."

His final bit of advice: "The trick is, you don't want to be Howard Hughes" holed up at home, "but at the same time you want to take what are reasonable, practical, prevention steps" to stay well and enjoy your summer.

Video: HOW TO NOT GET SICK | 3 tips to prevent getting sick during holidays

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